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<br /> <br />Fnrm~s~$ ~ Department of the Treasurys^fntemat Revenua.Serviee -~ - <br />[Rev. aeptamher7978)I - Cerii~cate, of Release ofi Federal Tax Lien-- <br />', <br />~)Strtgt er <br />r : Serlal Numb For Opnonaf Use fry Reeord(ny Ofllee - <br />, ,~ <br />** <br />!~ aia '. ~2aA <br />- <br />I certifytfi8t as tothe following-named taxpayer, the requirements of section t3325(a) Q <br />(t ~ ~ L+ 21~ <br />of the Internal Revenue Code have been satisfied for the taxes listed below and ~ ~ <br />O J V ~+ <br />for alt statutory additions. Therefore, the lien provided by Code section 6321 for <br />these tax6k and additions has been released. The proper ~fic~r in the office <br />v3tteie the notice of internal revenue tax lien was filed on <br />19 '' 81 is authorized to note the books to show the release of this Tien for <br />these taxes and additions. "" ~ <br />`~; <br />Name of Taxpayer <br />~~i <br />Residence ~1 ~~ ~d ~fbe 5 <br />FOSb *Iat I7~t <br /> Unpaid Balance <br />Kind of Tax Tax i'eriod Ended i~te of Assessment Identifying Number of Assessment <br /> <br /> <br />YtPib ~ ~•~~ <br />`~ Y~ <br />~ 4~"v a~ _ -. <br />f~ ~_ <br /> i <br />PIaCe;Of )ng . <br />,.. ~ ~ -- <br />- <br />rasa <br />s~ ~#-~tat3~ <br />;~ ; <br />This certificate was prepared and signed at Omaha , Nebraska , on this, <br />the3~n ._ day of September, <br />(Nolw CMlpura of ttilMa/uMnrizaC 4Y law m take acknowletlpmanh 8 not aaaantal ro Ms vaOAMy of Notka of _ <br />-~ FaaMnl Tax LNn D.C.N. 2aUQ tYbtF r, C.6• ryb.) <br />Part 3 - TO be used for reaoMing purposes Form MfQ (lieu. &78) <br /> <br /> <br /> <br />